Wednesday, May 12, 2004

Tragic end of the boy who was brought up as a girl

I'm including this, because I regard it as an example of a person who was used as an experiment. No justification, whether "scientific", religious, political or otherwise can justify messing with someone like this

Tragic end of the boy who was brought up as a girl
David Reimer was hailed by scientists as a triumph of nurture over nature. But as his suicide shows, this was a terrible mistake
By David Usborne
12 May 2004

Two weekends ago, 38-year-old David Reimer told his parents in their shared hometown of Winnipeg, Canada, that although he was going through a rough patch - recovering from the death of his twin brother two years ago and from his separation from his wife - things would getter better very soon. He didn't explain how.

Now his family knows. On 4 May, Reimer took his own life. While his recent ills surely contributed to the despair, his mother knows there was more to it than that. His death was the final coda to a life that became a world-renowned case study in the perils of tampering with gender. During the span of his life he had been a boy, then a girl and then a boy again. "I thought I was an it," he once said.

The wrenching story of David (baptised as Brian) Reimer began with a freak snowstorm in 1966. His parents, working-class people from the plains of Manitoba, drove him to the local hospital for a routine circumcision. He was eight months old. But the regular surgeon had not made it in and an assistant took over. She botched the job. A cauterising implement burned David's penis - and it fell off. A witness later said that when the mistake was made there was a sizzling sound, like a steak being seared.

Left with a child with testicles but no penis, his parents were unsure what to do. Then, one day when the boy was more than a year old, they learned about a doctor in Baltimore who had gained a reputation of helping people of ambiguous gender. His name was John Money and they went to see him.

It was Money, a native of New Zealand and the author of some 40 books on human sexuality, who persuaded them that the best course of action was to transform their son into a daughter. He recommended surgery, including clinical castration, and hormone treatment to turn young Brian into a girl. His parents agreed and the treatment began. Brian became Brenda and long trousers gave way to skirts.

For Money, who had pioneered studies in sexology at Baltimore's prestigious John Hopkins University, it was an irresistible challenge. He was a main proponent at the time of the theory that was briefly popular in the Sixties and Seventies, that gender identity was not necessarily predetermined in the womb. It was more about environment. In the controversy that still rages today over the balance between nurture and nature in determining our sexual selves, Money was a hero of the camp favouring nurture.

Better still for Money, the Reimer case offered an unheard-of opportunity to prove his theory. The patient had an identical twin brother, who was indisputably male. He had an experiment, therefore, with a readily supplied control subject. Two human beings conceived in the same womb with the same genetic profile. But nurture, with help from the knife and some pills, would demonstrate how their gender paths could be separated for ever.

And all seemed to go well. All remnants of Brenda's male genitalia were gone and her parents did all they could to raise her as a daughter. All the while, the so-called John/Joan case, expounded with pride by Money, a fine writer and charismatic lecturer, was celebrated by science and sociologists everywhere. The gender-fixing procedure was adopted at hospitals worldwide. And the Money theory was also embraced by the then burgeoning feminist movement as proof that social expectations of gender were misplaced. The male-female axis, they declared, was not set in stone. It was fluid and dynamic.

The John/Joan case also helped inform treatment of hermaphrodites, who are born with genitalia so ambiguous that hospitals cannot determine whether at birth the babies are boys or girls. In the vast majority of these cases, parents are told that their children should be raised as girls. Meanwhile, Money's reputation continued to grow. Considered one of the world's leading sexologists, his books included The Breathless Orgasm (1991), Venuses Penuses (1986) and Gay, Straight and Inbetween (1988.)

But things in the Reimer household were not as people imagined. It was only in 2000 that the true story of Reimer's experience reached a wide public. By then, out of dresses and bras and back in the world as a boy, Brian - by then renamed David Reimer - had decided that enough was enough. The truth had to be told. By going on Oprah Winfrey's show and collaborating on a book with a well-known New York journalist, he revealed that Money had consigned him to a childhood of humiliation, confusion and misery.

"David was a hero," said Milton Diamond who collaborated on the first scientific papers to expose the disaster of the John/Joan case. Commenting on his death, he said: "David didn't give permission for what was done to him. Even though he didn't have a penis, he still knew he was male."

It was when Reimer was 13 and in therapy with a counsellor provided by the Winnipeg school system that he learned for the first time what had happened to him. Already he had been stigmatised by fellow classmates. They had seen his ungainly gait, the muscles that, despite the removal of his testicles, had begun developing on his neck and arms, and his lack of interest in boys. "They wouldn't let him use the boys' washroom or the girls'," his mother, Janet Reimer, recalled. "He had to go in the back alley."

That was when he rebelled, demanding that he be allowed to go through more surgery to restore his manhood. It was a transition that would be traumatic for any person, let alone someone in their early teens. The breasts that had developed because of the hormone injections were removed by mastectomy. And he opted for reconstructive surgery to build back the penis of which he had been robbed after birth.

The debunking of what Money had wrought first began with the publication of the paper written jointly by Diamond and also Dr Keith Sigmundson, who was the supervising psychiatrist for Reimer from the age of eight until 20. Published in the relatively obscure Archives of Pediatric and Adolescent Medicine in 1997, it outlined Reimer's rejection of being a girl.

"By the time Reimer was 11, the whole experiment was falling apart," noted Sigmundson. "From that point on he sought out all the surgery. He totally changed how he was presenting himself and struggled with a number of operations. He eventually lived his life as a man."

Sigmundson added that the case should serve as a caution to those still drawn to the nurture over nature idea. "There are certain immutable things that happen in your chromosomes and in utero that develop the gonads that have an impact. Reimer didn't adjust well to being a girl at all and began having difficulties at school."

Most experts today contend that there is no overriding the gender determinants that are in a person before birth. But that does not mean that environment does not play some part. "The Reimer case has taught a lot of people in the field that things are a lot more complex when it comes to gender than people originally thought 30 years ago," argued Ken Zucker, who is chief psychiatrist at the Toronto Center for Addiction and Mental Health.

"Where we've really had a lot of advances is in recognising biology has a predisposing influence on gender identity and gender roles. But the environment is also important."

Diamond was shocked by the news of Reimer's death. But he hoped lessons had been learned. "His life was very difficult. I think the legacy is the whole issue of how people identify and see themselves as male and female. It's not as simplistic as putting people into blue rooms and pink rooms. Certainly our environment makes a difference and how we're brought up makes a difference. But we come to the game with our own inherent natures and how those things interplay can't be predicted."

It was the book, written with Rolling Stone journalist John Colapinto, entitled As Nature Made Him: the Boy who was Raised as a Girl, that brought the calamity of Reimer's situation to the attention of the world. He was inspired to write it after seeing an account of the Diamond-Sigmundson paper in the New York Times. Colapinto cast Money as the villain of the story, although the doctor, who is now 83, never publicly responded to it. The appearance with Oprah Winfrey coincided with its publication. "I thought the Reimers were just the most dignified, fantastic people," Colapinto commented in an interview at the time. "I think in a way these wonderful working-class people from Winnipeg just kind of stepped onto the world stage on Oprah and were a lesson to us all in dignity and survival and openness and courage."

"Scientists had just relied on this case as being a precedent for the fact that you could assign the sex and gender to children," Colapinto added. And his book had a strong impact. "Those who believed that and taught it and based their clinical practice on it, and who actually performed similar procedures, were scandalised."

The same sense of scandal was what drove Reimer to collaborate with the journalist and expose his pain to the world. He was angry about what had happened to him and by the discovery that Money's tampering with him was being replicated in clinics and hospitals around the world. He wanted it to stop.

"I was surprised that other people wound up going through what I had, because of my so-called 'success story' that wasn't so much of a success," he said. "You were expected to wear girl's clothing and to behave in a certain manner and you were expected to play with girl's toys." But he never believed he was a girl. "I thought it was very ignorant for them to think I was no longer a male because my penis was burned off. A woman who loses her breasts to cancer doesn't become any less of a woman."

His family is left now to grieve for a loved one who was subjected to such humiliations without his consent. For a while, there had been hope that he had put his life back on the rails. While the years of treatment had given his features the fine lines of femininity, he was widely accepted in Winnipeg as a man once more. He got menial jobs and finally found a wife. He became stepfather to her three children.

The loss of his brother, his family said, hit him hard. His twin had also taken his own life and for the past two years, David had made the pilgrimage to his brother's grave every day to arrange fresh flowers. Then the wife with whom he had established the traditional male role walked away, with her children. He slumped into depression. Worse came soon after when he lost his job. His mother, Janet, came closer than anyone at the funeral last Sunday to blaming Money for what had happened to her child.

"He was a hero," she whispered to a reporter. "He showed the doctors, he was a worldwide hero." Asked why she thought he had finally taken his own life, she responded: "I think he felt he he had no options. It just kept building up and up." His father, Ron, shook his head when approached by reporters and said he had nothing to add.

Janet, however, tried to pay tribute. "He was the most generous, loving soul that ever lived. He liked music. He liked jokes. He was a very funny guy. He was so generous. He gave all he had."
12 May 2004 11:37

2 comments:

This is a sad story. But, it's also interesting. It makes you think about gender roles and sexuality, and how much social pressure is brought to bear on each of us to play the role in society we're "born into".

Stay in your box! Do what is expected of you! Pay your taxes and die! No suprises!

It certainly throws a spanner in the works for those people who think, for example, that homosexuality is something that can be "cured". Reimer's case shows that gender and sexuality are not formed entirely by social pressures, but are also, in some way, "hardwired" into the human brain.It should make people think again that sexuality is natural, whether hetero-, homo- or bisexuality. The question that still can't be answered, though, is how much is natural (from the inside), and how much is societal (from the outside).

It is indeed a sad and interesting story. People seeking more might want to read "Middlesex" by Jeffrey Eugenides, which is a fictional version of a similar story. I only found one factual error in this blog's retelling of David's story. He was actually born and baptised "Bruce," and his identical twin brother was Brian, not the other way around.